Keeping Me Well - Cardiff and Vale University Hospital

Lower Back Pain

How does the back work?

The spine, which is also called the backbone or spinal column, is one of the strongest parts of the body and gives us a great deal of flexibility and strength. It’s made up of 24 bones, known as vertebrae, one sitting on top of the other. These bones have discs in between and lots of strong ligaments and muscles around them for support.

As you grow older, the structures of your spine remain strong, but it’s usual for your back to get stiffer as you get older.

Spine with lower vertebrae marked in red signalling pain

Most people suffer from lower back problems  at some point in their lives. They are very common. The majority of the time it doesn’t mean actual damage to your back.

If it’s a new thing, often you don’t need to seek advice from a medic or therapist for your lower back problem. X-rays, scans and treatment are not usually needed.

As far as possible, it’s best to continue with your normal everyday activities as soon as you can and to keep moving.

Being active and exercising won’t make your back pain worse, even if you have a bit of pain and discomfort at first. Staying active will help you get better. Taking painkillers can also help you do this.  Nearly all low back pain begins to fade within two weeks and settles within six weeks. For more information about long lasting low back pain see our 10 back facts leaflet. 

Occasionally patients with low back pain will have low back related leg pain. Some patients will only have leg pain and not experience low back pain.

If you have low back related leg pain you may have sciatica or lumbar spinal stenosis.

About half of people with sciatica, (a type of low back related leg pain) will have significant improvement by 12 weeks without any specific treatment.

  • A sprain/strain for example sports-related or work-related (lifting something awkwardly or something that is too heavy for what you are physically conditioned for).
  • A sudden increase or decrease in your normal exercise/activity levels.
  • A number of factors have been associated with low back pain including periods of increased stress, worry or low mood. Poor sleep, fatigue, smoking or being run down are factors also associated with low back pain.
  • Often the cause of lower back problems are not certain and the best course of action is to concentrate on the things that may help.

If you would like advice about medication or other methods of pain relief to help you to manage your pain better speak to your community pharmacist.

Pain medication can help to reduce pain and help you to move more comfortably, which can aid your recovery.

When taking pain medication it is important to take it regularly.

ESCAPE Pain Programme for Back pain

ESCAPE for back pain is a group rehabilitation programme specifically designed for people with back pain.

The programme is delivered by a team of rehabilitation professionals at your local leisure centre. You will attend 12 sessions in total – twice weekly for 6 weeks, learning strategies and exercises to help you to better manage your symptoms.

To learn more about ESCAPE Pain and to refer yourself to the programme, follow this link.


At Cardiff and Vale University Health Board we are offering a session called MANAGE BACKS, which aims to help you manage low back pain.

Click here to find out more about the MANAGE BACKS session.

In very rare cases lower back related problems require immediate attention

This video will help you to understand when you might need to seek urgent help for your back pain.

Cauda Equina Syndrome which, was discussed in the video, requires immediate attention on the same day. Some of the warning signs of cauda equina syndrome are:

  • Loss of feeling/pins and needles between your inner thighs or genitals.
  • Altered sensation and/or pain consistently in both legs at the same time.
  • Numbness in or around your back passage or buttocks.
  • Changes to bladder function, such as loss of sensation, loss of control or an inability to empty your bladder.
  • Sexual problems such as loss of vaginal sensation and inability to achieve an erection or ejaculate.

If you experience any of the above contact NHS 111 or your GP immediately.

For further information please see the Cauda Equina Syndrome Card

Please watch this video on how to pace your exercise before starting the exercises.

If during the video you are experiencing significant pain please stop the video and seek advice from your GP.

Exercise for Lower back pain:

Spinal Flexibility Class (Seated)

Thoughts and Emotions When In Pain

Pain & Me

Play Video

Psychology in People with Pain – Why it Matters (Parts 1 and 2)

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